CSY Chan, ACC Fu

Abstract

Objectives: To evaluate the prevalence and severity of depressive symptoms in paediatric diabetes mellitus (PDM), and identify factors associated with the development of depressive symptoms. Research Design and Method: The Patient Health Questionnaire-9 (PHQ-9) was completed by 90 paediatric patients with diabetes from year 2020-2022 who received regular follow up in Princess Margaret Hospital. Data including demographics and characteristics of patients were collected and analysed. Results: Sixteen out of 90 patients (17.8%, 95% CI: 9.9%-25.7%) reported moderate or above severity of depressive symptoms as defined by a PHQ-9 score ≥10. 13.7% and 12.2% of patients had a PHQ-9 score ≥10 in year 2021 and 2022 respectively, compared to none in year 2020. Higher body mass index (p=0.048), presence of diabetic-related complications (p=0.049), greater number of hospital admissions related to poor diabetic control (p=0.003), poor family dynamics with parental marital conflicts (p=0.002) and parent-child relationship problems (p<0.001), known psychological or behavioural problems (p<0.001) were identified as factors associated with increased risk for developing depressive symptoms. Patients who used continuous glucose monitoring system (p=0.014) and had more frequent blood sugar monitoring (p=0.002) were associated with less risk for developing depressive symptoms. A higher HbA1c value (p=0.023) was found to be positively related to depressive symptoms in the subgroup analysis for patients with type 1 DM but not type 2. Conclusion: Depressive symptoms are common in PDM patients. Regular mental health screening by using a validated self-reported questionnaire is a cost-effective and reliable method that should be advocated in all eligible PDM patients.